Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: A randomized controlled trial

David J. Wilber, Carlo Pappone, Petr Neuzil, Angelo De Paola, Frank Marchlinski, Andrea Natale, Laurent Macle, Emile G. Daoud, Hugh Calkins, Burr Hall, Vivek Reddy, Giuseppe Augello, Matthew R. Reynolds, Chandan Vinekar, Christine Y. Liu, Scott M. Berry, Donald A. Berry

Research output: Contribution to journalArticle

Abstract

Context: Antiarrhythmic drugs are commonly used for prevention of recurrent atrial fibrillation (AF) despite inconsistent efficacy and frequent adverse effects. Catheter ablation has been proposed as an alternative treatment for paroxysmal AF. Objective: To determine the efficacy of catheter ablation compared with antiarrhythmic drug therapy (ADT) in treating symptomatic paroxysmal AF. Design, Setting, and Participants: A prospective, multicenter, randomized (2:1), unblinded, Bayesian-designed study conducted at 19 hospitals of 167 patients who did not respond to at least 1 antiarrhythmic drug and who experienced at least 3 AF episodes within 6 months before randomization. Enrollment occurred between October 25, 2004, and October 11, 2007, with the last follow-up on January 19, 2009. Intervention: Catheter ablation (n=106) or ADT (n=61), with assessment for effectiveness in a comparable 9-month follow-up period. Main Outcome Measures: Time to protocol-defined treatment failure. The proportion of patients who experienced major treatment-related adverse events within 30 days of catheter ablation or ADT was also reported. Results: At the end of the 9-month effectiveness evaluation period, 66% of patients in the catheter ablation group remained free from protocol-defined treatment failure compared with 16% of patients treated with ADT. The hazard ratio of catheter ablation to ADT was 0.30 (95% confidence interval, 0.19-0.47; P

Original languageEnglish
Pages (from-to)333-340
Number of pages8
JournalJournal of the American Medical Association
Volume303
Issue number4
DOIs
Publication statusPublished - Jan 27 2010

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: A randomized controlled trial'. Together they form a unique fingerprint.

  • Cite this

    Wilber, D. J., Pappone, C., Neuzil, P., De Paola, A., Marchlinski, F., Natale, A., Macle, L., Daoud, E. G., Calkins, H., Hall, B., Reddy, V., Augello, G., Reynolds, M. R., Vinekar, C., Liu, C. Y., Berry, S. M., & Berry, D. A. (2010). Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: A randomized controlled trial. Journal of the American Medical Association, 303(4), 333-340. https://doi.org/10.1001/jama.2009.2029